ICD-10 Coding for Mononucleosis(B27.00, B27.09)
Complete ICD-10-CM coding and documentation guide for Mononucleosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mononucleosis
B27.0-B27.9Primary Range
Viral mononucleosis
This range covers mononucleosis caused by specific viruses such as EBV and CMV, including complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B27.00 | Infectious mononucleosis due to Epstein-Barr virus without complications | Use when EBV is confirmed as the cause and no complications are present. |
|
| B27.09 | Infectious mononucleosis due to Epstein-Barr virus with other complications | Use when EBV is confirmed and complications are present. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for mononucleosis
Essential facts and insights about Mononucleosis
Primary ICD-10-CM Codes for mononucleosis
Decision Criteria
clinical Criteria
- Confirmed EBV infection with no complications
Applicable To
- EBV mononucleosis without complications
Excludes
- Chronic fatigue syndrome (R53.82)
Clinical Validation Requirements
- Positive EBV VCA-IgM serology
- Presence of atypical lymphocytes
Code-Specific Risks
- Incorrectly coding without confirmed EBV serology
Coding Notes
- Ensure EBV is confirmed through serology before using this code.
B27.09 - Infectious mononucleosis due to Epstein-Barr virus with other complications
Use when EBV is confirmed and complications are present.
Applicable To
- EBV mononucleosis with complications such as hepatitis
Clinical Validation Requirements
- Positive EBV VCA-IgM serology
- Documented complications like hepatitis or splenomegaly
Coding Notes
Ensure all complications are documented and coded.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mononucleosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B27.00.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always confirm virus type with lab results, Use specific codes when possible
Impact
Reimbursement: Incorrect coding may lead to reduced reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Include splenomegaly as a complication under B27.09 if due to EBV.
Impact
High risk of audit if unspecified codes are used without attempts to identify the virus.
Mitigation Strategy
Ensure virus type is confirmed and documented.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Mononucleosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mononucleosis
Use these documentation templates to ensure complete and accurate documentation for Mononucleosis. These templates include all required elements for proper coding and billing.
Emergency Department Note
Specialty: Emergency MedicineRequired Elements
- Patient demographics
- Symptom duration
- Physical exam findings
- Lab results
- Diagnosis
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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